Newer hypnotic drugs for the short-term management of insomnia: a systematic review and economic evaluation

Dundar Y, Boland A, Strobl J, Dodd S, Haycox A, Bagus A, Bogg J, Dickson R, Walley T
Record ID 32004000329
English
Authors' objectives:

This study aims to assess the clinical and cost-effectiveness of zaleplon, zolpidem and zopiclone (Z-drugs) compared with the benzodiazepines licensed and approved for use in the UK for the short-term management of insomnia.

Authors' recommendations: There are clear research needs in this area; in particular, none of the existing trials adequately compare these medications. We would urge, therefore, that further consideration should be given to a formal trial to allow head-to-head comparison of some of the key drugs in a double-blind randomised controlled trial lasting at least 2 weeks, and of sufficient size to draw reasonable conclusions. We would also recommend that any such trial should include a placebo arm. It should also collect good-quality data around sleep outcomes and in particular quality of life and daytime drowsiness. We do not believe that any formal study of risk of dependency is feasible at present. Finally, the major research issue is perhaps not around the management of short-term insomnia, but around the management of long-term insomnia: considering the frequency of this symptom and its recurring course, the short-term trial of medication and lack of long-term follow-up undermine attempts to develop evidence-based guidelines for the use of hypnotics in this condition, or indeed for its whole management.
Authors' methods: Systematic review
Details
Project Status: Completed
URL for project: http://www.hta.ac.uk1362
Year Published: 2004
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: England, United Kingdom
MeSH Terms
  • Costs and Cost Analysis
  • Hypnotics and Sedatives
  • Sleep Wake Disorders
  • Sleep Initiation and Maintenance Disorders
Contact
Organisation Name: NIHR Health Technology Assessment programme
Contact Address: NIHR Journals Library, National Institute for Health and Care Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK
Contact Name: journals.library@nihr.ac.uk
Contact Email: journals.library@nihr.ac.uk
Copyright: 2009 Queen's Printer and Controller of HMSO
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